Abstract
Objective
To estimate the impact of the major components of the ACA (Medicaid expansion, subsidized Marketplace plans, and insurance market reforms) on disparities in insurance coverage after three years.
Data Source
The 2011-2016 waves of the American Community Survey (ACS), with the sample restricted to nonelderly adults.
Design
We estimate a difference-in-difference-in-differences model to separately identify the effects of the nationwide and Medicaid expansion portions of the ACA using the methodology developed in the recent ACA literature. The differences come from time, state Medicaid expansion status, and local area pre-ACA uninsured rates. In order to focus on access disparities, we stratify our sample separately by income, race/ethnicity, marital status, age, gender, and geography.
Principal Findings
After three years, the fully implemented ACA eliminated 43% of the coverage gap across income groups, with the Medicaid expansion accounting for this entire reduction. The ACA also reduced coverage disparities across racial groups by 23%, across marital status by 46%, and across age-groups by 36%, with these changes being partly attributable to both the Medicaid expansion and nationwide components of the law.
Conclusions
The fully implemented ACA has been successful in reducing coverage disparities across multiple groups.
Document Type
Article
Publication Date
2-2019
Digital Object Identifier (DOI)
https://doi.org/10.1111/1475-6773.13077
Repository Citation
Courtemanche, Charles J.; Marton, James; Ukert, Benjamin; Yelowitz, Aaron; Zapata, Daniela; and Fazlul, Ishtiaque, "The Three-Year Impact of the Affordable Care Act on Disparities in Insurance Coverage" (2019). Economics Faculty Publications. 11.
https://uknowledge.uky.edu/economics_facpub/11
Supporting information file 1
hesr13077-sup-0002-figures1.docx (37 kB)
Supporting information file 2
hesr13077-sup-0003-tables1-9.docx (99 kB)
Supporting information file 3
Notes/Citation Information
Published in Health Services Research, v. 54, issue S1.
© 2018 The Authors
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.